The changing bacteriological profile of neonatal sepsis in a tertiary care hospital – Emergence of Citrobacter septicemia

Abstract

Neonatal Mortality Rate (NMR) is one of the indicators of health status of a nation and neonatal sepsis is one of the commonest causes of NMR contributing to 19% of all neonatal deaths in India. All over India, there is a gradually increasing trend of multi-drug resistant (MDR) pathogens in neonatal intensive care units (NICU) and special newborn care units (SNCUs) in tertiary care hospitals.To determine the changing trend in the bacteriological profile of neonatal septicemia and their antibiotic susceptibility pattern (AST).It is a retrospective study conducted on total 452 blood culture samples collected from SNCU over 1-year period from July 2017 to June 2018 in tertiary care government hospital. Organisms were identified by the standard protocol and their antimicrobial susceptibility testing was determined as per latest CLSI guidelines.out of 452 blood culture of neonatal septicemia patients, 138 cases (30.53%) were culture positive Most common isolated gram negative organism was spp. 55/138 (39.85%) followed by spp. 23/138 (16.66%). Most common isolated gram positive organism was 25/138 (18.11%) followed by Coagulase Negative Staphylococcus (CONS) (8.69%). Among gram negative isolates most sensitive antimicrobial was Imipenem (87.6%) followed by Levofloxacin (87.4%) and Piperacillin + Tazobactam (46%) and resistant to, Cotrimoxazole, Amoxicillin + clavulanate and 3rd generation Cephalosporins.spp. is the predominant organism of neonatal sepsis in the Indian subcontinent, although significant rise in proportion of spp. is occurring. High resistance to cephalosporins is a cause of concern, as they are one of the most common prescribed antibiotic groups.